Dispelling nutrition myths, ranting, and occasionally, raving

Tag Archives: supplements

I read this article about a “new app that identifies your nutrition gap” a little while ago. According to the article, the app (Healthspan) will make individualized supplement recommendations that you can order in-app based on your diet. Naturally, I was concerned. Ideally, we should be aiming to obtain the majority of our nutrients from food. I envisioned an app designed to push supplement sales and was concerned about the safety and accuracy of recommendations made through an app. I figured I shouldn’t knock it until I tried it though so I downloaded the free app and tried it out for a week.

Healthspan is very similar to other food and activity tracking apps in that you enter your daily food consumption and your physical activity. I’ve written about some of the pitfalls of these apps before, in particular their accuracy when it comes to calories burned and the notion of “earning” more food with exercise.

When you first download Healthspan you enter your weight, height, age, etc and it gives you your daily caloric intake to attain your goal. According to the app, for me to maintain my current weight I should consume 1143 calories a day. This is quite low and certainly lower than the number of calories I actually consume every day. Of course, I “earn” more calories through my regular exercise. Just for fun I changed my goal to see what my daily caloric allotment would be if I wanted to lose two kilos. I now have a measly 914 calories per day to work with. To put that in perspective that’s roughly the calories in a Big Mac and medium fries. A 900 calorie per day diet is generally considered to be a very low calorie diet and not recommended to be undertaken without medical supervision. The app however, provided me with no warning. It just readily lowered my daily calorie goal. Interestingly, when I further decreased my goal weight to 44 kg (which would render me significantly underweight for my height) my calorie goal remained at 914/day.

Healthspan does offer you the opportunity to obtain free supplement samples when you register. Unfortunately, they’re only available to those in the UK so I was unable to determine what the samples were. Following that, you can order supplements through the app but the description of this process given in the original article is a little off-base. The app doesn’t make recommendations based on your recorded dietary intake. Rather, you complete a questionnaire and based on your responses it recommends a multivitamin supplement. The recommendation seemed pretty generic for any woman of my age (see below). Despite this, it still concerns me that supplements are available through the app given the questionable quality and safety of many supplements available on the market.

Aside from this, another rather significant issue I had with the app was logging my food intake. While it was quite user-friendly to enter foods and beverages I’d consumed, the selection was extremely limited and there was no way to determine ingredients in mixed dishes, nor to enter your own recipes or nutrition information. For example, I made a vegetable curry for supper one evening. There was a vegetable curry option I could add but there was no way of knowing if the ingredients were similar to the curry I ate and for anyone who’s ever had curry, you know that the recipes can vary considerably. The same held for other dishes such as smoothies, lasagna, granola, stir-fry, and so on. There was also a number of foods that I couldn’t find at all in the database and had to make my best guess at what would be most similar. Based on this, I question the ability of the app to record calorie and nutrient intake even remotely accurately.

Each day, the app gives you a score out of 100 that appears to be based on your physical activity and calorie consumption. However, participation in challenges also counts toward this score. Without participating in these optional challenges, I was never able to achieve better than a 60 on any one day. On most days, I was even lower than this. Personally, even though I wasn’t using the app to genuinely achieve any goal, I found this really discouraging. If I was actually trying to reach personal nutrition and physical activity goals I can imagine this score would be off-putting.

I know that people really like apps to track things like food and exercise but I’d give Healthspan a pass if you’re looking for an app for these things.

Last week the news that pregnant women don’t need vitamin supplements seemed to be all over social media. The articles were based on this review article published in the Drug and Therapeutics Bulletin. The authors concluded that based on the evidence, much of which was from research in developing nations, that women (in Britain) do not need to take prenatal vitamins.

They reached this conclusion based on examining studies of the effects of folic acid, vitamin D, iron, vitamin C, vitamin E, and vitamin A supplementation on birth outcomes. While they concluded that multivitamin supplements are unnecessary for women during pregnancy, they stated that there was strong evidence to support women taking folic acid supplements and vitamin D supplements during pregnancy.

The message that came across most strongly (from the news articles) to me was that women are being shamed into purchasing vitamins that they can ill-afford, and don’t need, under the guise of wanting the best for their baby. The implications of these news articles concern me.

Firstly, women should be aware that many pharmacies (in Canada at least) have prenatal programs through which pregnant women can receive free multivitamin supplements, amongst other things. An inability to afford multivitamins should not prevent women from receiving them. Let’s not make this about drug companies trying to make money from poor women desperate to do the best for their unborn children. This should be about doing the best for women and their unborn children.

Okay, now that, that’s out of the way… I worry that the message that women should still be taking folic acid supplements and vitamin D supplements (and not just pregnant women I should add as most women of childbearing age should be taking folic acid supplements and most women in North America at least, should be taking vitamin D during the winter months) will be lost amid the cry that multivitamins are unnecessary. The message is not that all vitamin supplements are unnecessary for most Western women during pregnancy, just that the current evidence doesn’t support the use of multivitamins.

I’d also like to note that the researchers were focussing on birth outcomes. The conclusion that multivitamins are unnecessary was based on whether or not mums gave birth to healthy full-term babies. The authors did not take into consideration any potential long-term benefits maternal supplementation might have on their children. The authors did not take into consideration benefits that multivitamin supplementation might provide to mums. They did note that multivitamins can lower the mums risk of anemia, but as that didn’t seem to affect birth outcomes iron supplementation was deemed unnecessary. There are many other vitamins and minerals in multivitamins that the authors didn’t look at. Quite likely there’s not enough research on them to make a call either way. Regardless, the needs of pregnant women, not just their babies, should be taken into consideration when determining whether or not supplements are needed. Not all mums are going to get all the nutrients they need from food. Especially if they’re suffering from “morning” sickness. Perhaps not all mums will benefit from taking multivitamins. However, some very well may, and I think it would be a shame to tell them that they’re “wasting their money”.

Finally, as my friend Mark (who asked me to write about this topic) mentioned, taking two pills is more effort than taking just one. If it’s still being recommended that women take folic acid and vitamin D during pregnancy then they may as well just get those nutrients from a prenatal multivitamin rather than buying separate bottles of two supplements and having to remember to take both pills. It may be ever so slightly less expensive to buy vitamin D and folic acid instead of a multivitamin but I can’t even be certain of this because there was no folic acid for sale at my local grocery store when I went to price them all out. Which raises the issue of availability as well.

Women shouldn’t be made to feel guilty about not being able to afford a prenatal multivitamin. They also shouldn’t be made to feel like they’re wasting their money by buying them.

A little while ago when I was looking for blogspiration a friend told me to take a look at a certain “nutritionist” on twitter. Since then, I’ve had her on my back burner because she certainly looked like she would have some good blog fodder (cured her incurable illness through diet) but I couldn’t be bothered to look through all her posts. Well, today’s the day I move her to the front burner.

I was reading her post on the healing properties of aloe. I found myself hoping that she would provide a balanced picture because I didn’t really want to write about aloe. Sadly, she did not, so here we are. As I feel that simply extolling the virtues of a food, without providing cautions is irresponsible, even if you don’t have a regulatory body protecting the public from you. Sorry, sorry, I digress.

In her post she writes about the magical properties of aloe: anti-viral, anti-bacterial, anti-inflammatory. Unfortunately, there she didn’t link to any research so I can’t comment on the quality of the studies used to make these claims. As far as I can tell, to date there’s been very little (if any) research on human subjects. However, some in vitro studies and animal have shown some promise when it comes to the anti-viral (1, 2) and anti-microbial (3, 4) properties of aloe vera. Of course, based on the current research, there’s no way to know what dose or form of aloe would (if at all) be effective in humans. It’s entirely possible that oral ingestion of aloe would not have any positive benefits in relation to viruses and bacteria.

Some mouse studies and in vitro have shown promising wound healing and anti-inflammatory effects of aloe vera (when administered both topically and orally) (5, 6). Again, there has yet to be any conclusive research done in humans.

Okay, it sounds a bit promising but… Then come the concerns. Before you start adding a handful of aloe vera plant to your smoothie you should be aware that the exterior portion of the leaf has a laxative effect. There are other longer lasting concerns about aloe vera consumption than diarrhea. My friend Helen has written about many of them on her blog Food and Nonsense. These include a risk of cancer and impaired liver function. Over at Examine, the only conclusive research they’ve found so far for aloe supplementation is for increased intestinal motility (i.e. to combat constipation). The Mayo Clinic provides a long list of cautions against the ingestion of aloe vera products, including the risk of inducing uterine contractions in pregnant women. I’ve also blogged about the consumption of aloe vera juice in the past.

I believe that my final statement in that post stands the test of time: Just because it’s “natural” doesn’t mean it’s good for you.

I found it a little alarming that Huffington Post would publish an article containing medical advice on diabetes management by a naturopath. Not surprising, but alarming.

To be perfectly honest, most of her advice wasn’t terrible (therein lies the worst aspect of naturopathy, it’s often truth laced with completely unscientific bullshit).

Managing carbohydrate intake and cutting back on foods such as white bread can be beneficial. Although, you don’t necessarily have to completely remove all of these foods from your diet and other foods can also lead to spikes in blood sugar.

Getting daily exercise is also great; for anyone, not just someone with type 2 diabetes. Although, touting it as the tool for weight loss is misleading. Most weight loss results from changes in the kitchen, not changes in the gym.

The supplement suggestions make me extremely uncomfortable for several reasons. First of all, naturopaths sell supplements in-house and this is a massive conflict of interest. A medical professional should not profit from the “treatment” they provide to a patient. Secondly, there is insufficient scientific evidence to support supplementation with the remedies she recommends.

The most alarming aspect of this article, in my opinion, is that it’s providing medical advice via a publicly posted article. Treatment of type 2 diabetes (or any other medical condition) should be undertaken with appropriate medical supervision. Without first consulting with your doctor and/or pharmacist there’s no way to know what effect the supplements she recommended might have on an individual. They may be contraindicated for a medication that a person is taking or they may cause other side effects. Even making dietary changes should be done in consultation with your primary healthcare provider. If you’re taking medication for diabetes, making changes to the amount and timing of carbohydrate you’re consuming can affect the way in which your medication works.

If you suspect that you have diabetes, please see your doctor or nurse practitioner for a diagnosis. If you’re currently on medication for diabetes please consult with any/all of the aforementioned medical professionals before making any drastic lifestyle changes and certainly before undergoing any additional supplementation.

In case you missed it last week, the Internets got their collective panties in a twist about this article sharing a typical day of food for the founder of Moon Juice.

Moon Juice, for those such as myself who are not in the know, is ostensibly the most popular juice bar in LA.

Pardon me for not being surprised that her diet includes ridiculous things that I’ve never heard of before and am not entirely convinced are actually food. Things like Brain Dust and quinton shots. Ugh.

People immediately began decrying her diet. Just for fun, I decided to do a completely unscientific analysis of the nutrient content of her food to see just how her food stacks up when compared to a diet of recognizable food items. I used the nutritional info listed for the products on the Moon Juice website where I could. For everything else I just googled for nutrition information. I only looked at macronutrients, so it remains to be told how nutritious her diet is in terms of micronutrients.

Snack: (Nutrition info for Heart Tonic is unknown, estimating the nutrient values for the chocolate based on single servings of all the ingredients mentioned) 174 kcal, 5g CHO, 3g fibre, 4.5g fat, 21g protein – I find it hard to believe that this chocolate is remotely palatable without any added sugar but maybe that’s just me.

I must confess, I’m a little disappointed that her diet didn’t show any glaring imbalances. Overall, it’s maybe a little low in carbs, and a little high in protein and fat and sugar. But essentially, it’s actually fairly well balanced.

I would be a little concerned about calcium, vitamin D, and vitamin B12 consumption for someone following this diet. Also, the sodium is quite high. Not knowing her energy requirements it’s hard to say whether or not 1700 kcal is adequate. That would depend on her height, weight, level of activity, and resting metabolic rate.

Even though this diet is not horribly balanced I still wouldn’t recommend it to anyone. Why? Well, variety is very important in a balanced diet. Based on the fact that she seems to eat essentially the same things every day she’s quite likely not getting all of the micronutrients that she needs. She may also be getting excessive amounts of others through her supplements.

Speaking of the supplements, there’s quite a few ingredients in there that are questionable at best. I don’t think that anyone can say with any degree of certainty that they’re safe to consume on a regular basis. Although one can say with a fair degree of certainty that they won’t live up to the claims. They’re definitely not worth the hefty price tags. Although if you’re willing to spend $55 for a 25 serving jar of Brain Dust then you probably need all the help you can get maintaining “healthy systems for superior states of cognitive flow”.